Yamagiwa H
Department of Clinical Pathology, Mie University School of Medicine, Tsu.
Jpn J Cancer Res. 1989 Mar;80(3):238-43. doi: 10.1111/j.1349-7006.1989.tb02299.x.
Isolated dysplasia was found in 46 (54 lesions) of 2,027 gallbladders, which were histologically studied by serial step sectioning. Average age of patients was 63.8 with a male-to-female ratio of 1 to 3. These lesions, excluding polypoid lesions of adenoma, were located most frequently in the fundus and body, showing flat granular or irregular appearance. As to the size, 68.6% were smaller than 1 cm in diameter (89% were smaller than 2 cm). Most mild dysplasias were found in small lesions less than 0.5 cm in diameter and moderate ones in lesions of less than 1.5 cm, though severe dysplasias were found in various sizes. Gallstones were found in 86.9% of the cases with dysplasia, and intestinal metaplasia and pseudopyloric gland metaplasis were found in 80.4% and 100%. Dysplasia adjacent to carcinoma was found in 46 of 110 cases (41.8%), and this change was frequently found in lesions at the early stage and well-differentiated carcinoma. It seems that mucosal damage caused by a stone and subsequent inflammation may be important in the histogenesis of intestinal metaplasia and dysplasia.
在2027个胆囊中，46个（54个病变）发现有孤立性发育异常，通过连续切片进行组织学研究。患者平均年龄为63.8岁，男女比例为1比3。这些病变（不包括腺瘤性息肉样病变）最常位于胆囊底部和体部，表现为扁平颗粒状或不规则外观。就大小而言，68.6%的病变直径小于1厘米（89%小于2厘米）。大多数轻度发育异常见于直径小于0.5厘米的小病变，中度发育异常见于小于1.5厘米的病变，不过重度发育异常可见于各种大小的病变。86.9%有发育异常的病例发现有胆结石，80.4%发现有肠化生，100%发现有假幽门腺化生。110例中有46例（41.8%）发现发育异常与癌相邻，这种改变常见于早期病变和高分化癌。似乎结石引起的黏膜损伤及随后的炎症在肠化生和发育异常的组织发生中可能起重要作用。
